Individual provider Active NPI

Manuel Fonseca-Crescioni, MD

  • Internal Medicine Physician
  • Aventura, FL
National Provider Identifier
1235688656
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME-157669 Issued in FL
Practice address
HCA Florida Aventura Hospital
20900 Biscayne Blvd
Aventura, FL 33180
Phone
(305) 682-7000
NPI assigned
Sep 27, 2016
Reactivated
Oct 17, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 35510-R PR
Internal Medicine Physician 207R00000X ME-157669 FL Primary

Addresses

Primary practice location

HCA Florida Aventura Hospital
20900 Biscayne Blvd
Aventura, FL 33180

Mailing address

20900 Biscayne Blvd
Aventura, FL 33180-1407

Other practice location 1

Carr 2 KM 173
San German, PR 00683
Phone (787) 892-1860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230301002160 FL Practitioner - Internal Medicine 5092188680 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seasons Medical Group of Florida PAGroup PAC ID 0941451314, 44 clinicians
Hospital Medicine Services of FL, LLCGroup PAC ID 9234596743, 513 clinicians

Practice addresses (Care Compare)

1200 S Pine Island Rd
Suite 350
Plantation, FL 33324-4409
Phone (954) 624-7900

20900 Biscayne Blvd
Aventura, FL 33180-1407
Phone (305) 682-7000

Hospital & facility affiliations

  • Accentcare Hospice & Palliative Care of Southern Florida Hospice, Miami, FL, CCN 101543
  • Accentcare Hospice & Palliative Care of Broward County Hospice, Plantation, FL, CCN 101555
  • Mount Sinai Medical Center of Florida, Inc Hospital, Miami Beach, FL, CCN 100034
  • HCA Florida Aventura Hospital Hospital, Aventura, FL, CCN 100131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME-157669FLMDInternal Medicine Physician
35510-RPRMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Ayala Troche, MD, C.S.P. CurrentSince Nov 15, 2020 Accepting new patients
Hospital Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients
Seasons Medical Group of Florida PA Internal Medicine CurrentSince Sep 23, 2024 Accepting new patients
Seasons Hospice & Palliative Care of Broward Florida LLC CurrentSince Sep 23, 2024 Accepting new patients
Catholic Palliative Care Services, Inc. CurrentSince Feb 21, 2023 Accepting new patients
Seasons Hospice & Palliative Care of Tampa, LLC Past Accepting new patients
Seasons Hospice & Palliative Care of Pasco County, LLC PastSince Nov 15, 2020 Accepting new patients

Locations

1815 Griffin Rd
Ste 410
Dania Beach, FL 33004
Phone (954) 624-7900

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

3487 NW 30th St
Lauderdale Lakes, FL 33311
Phone (954) 641-4200

3663 S Miami Ave
Miami, FL 33133
Phone (305) 285-2131

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

5200 NE 2nd Ave
Fl 3
Miami, FL 33137
Phone (305) 762-3883

4300 Alton Rd
Miami Beach, FL 33140
Phone (305) 481-9776

14875 NW 77th Ave
Ste 100
Miami Lakes, FL 33014
Phone (305) 351-7057

1200 S Pine Island Rd
Ste 350
Plantation, FL 33324
Phone (305) 223-2000

1408 N West Shore Blvd
Ste 260
Tampa, FL 33607
Phone (813) 607-2630

2644 Cypress Ridge Blvd
Ste 104
Wesley Chapel, FL 33544
Phone (813) 364-0311

17855 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 201-3800

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1235688656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20900 BISCAYNE BLVD",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HCA FLORIDA AVENTURA HOSPITAL",
            "address_2": "20900 BISCAYNE BLVD",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "33180",
            "telephone_number": "305-682-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "CARR 2 KM 173",
            "address_purpose": "LOCATION",
            "city": "San German",
            "state": "PR",
            "postal_code": "00683",
            "country_code": "US",
            "telephone_number": "787-892-1860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONSECA-CRESCIONI",
        "first_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-27",
        "last_updated": "2022-07-07",
        "certification_date": "2022-06-27",
        "deactivation_date": "2019-07-28",
        "reactivation_date": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "35510-R",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME-157669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.